Working together to change the system

When people work to change what happens for a whole group or community of people, it is called systems advocacy. Health systems advocacy aims to make positive changes to attitudes, policies, systems and laws in the health area. Its focus is on the rights and interests of health consumers.

Many of the groups that lobby for change have been created by people who have experienced issues and barriers within the health system. They have worked successfully to achieve change and improvements that make the system work better for anyone who uses it.

People working together around similar issues have a stronger voice which is more likely to be heard and leads to reforms that benefit many people.

People working together can:

help the community and its leaders to understand health issues and needs
assist people to have a say and put their views and interests forward
influence decision-makers to develop legislation which provides consumer-centred, safe and quality health services
generate changes to policy and procedures so consumers have better services
help people to get more resources
help consumers to exercise their healthcare rights
help consumers to have choice and control over their treatment and services
help consumers to get culturally appropriate services delivered in ways that respect their beliefs and values.

HCQ Advocacy Toolkit

Read about what systems advocacy means and tips to get you started. This article is from the excellent resource published by Health Consumers Queensland.

Read about what systems advocacy means and tips to get you started. This article is from the excellent resource published by Health Consumers Queensland “Getting the Health Care you need: An advocacy toolkit for people using the healthcare system in Queensland”.

Summary

Some systems advocacy is quite simple, for example, a group of neighbours getting together to prevent a new mobile phone tower being put up in their area. Other situations are more complex, for example, setting up an injecting drug room for illegal drug users. Most however, fall somewhere in between these two examples.

If you have an issue that you feel passionate about, don’t be afraid to have a go at systems advocacy. If you want to work with a friend, neighbour or colleague to make a change consider ‘taking the bull by the horns’ and look at some of the ideas in this kit. In the resource section you will find names of services that may be able to advise you.

Reproduced with permission from Health Consumers Queensland, “Getting the Health Care you need: An advocacy toolkit for people using the healthcare system I Queensland”.

Examples of system advocacy at work

In 2010, the Birth Centre of a major hospital was closed without warning, leaving many local women without their expected model of maternity care.

Upon hearing what had happened, local consumer organisations joined forces to support the centre and protest its closure. Through a combination of text messaging, emails and social networking websites, hundreds of people were notified of the centre’s closure within hours. Media estimated 300 – 500 people attended a rally outside the hospital the next morning, supporting access for women to birth centre care.

As a result of the rally and negotiations with consumer representatives, midwifery representatives and Government, the hospital decided to immediately re-open the Birth Centre while an independent review of maternity services led by a committee of doctors, midwives and consumers took place.

Some months after a patient had poor treatment in hospital, she was contacted by several other people who were also unhappy about the treatment they had received.

Together, they formed a support group, and began to lobby the Health Department and the Government for change. Their actions, in combination with the efforts of others, contributed to two Commissions of Inquiry and a major review of the health system. As a result, large scale reform and extra funding to the system has been obtained.

The State Government proposed to redevelop a hospital in a regional area and a redevelopment plan was developed.

A local health consumer group saw the plan and noted that it included only 15 hospital beds, and no private rooms or palliative care beds.

During the consultation process the group had several meetings with the Project Management Team and voiced their concerns about the inadequate number of hospital beds to service the local region; the absence of private rooms for patients with private healthcare; and the failure to accommodate patients in need of palliative care. The health consumer group undertook research and presented statistical evidence to the Project Management Team justifying consumer/patient need for more beds, private rooms, and palliative care beds, and engaged in ongoing discussions and negotiations about these issues.

As a result of the health consumer group’s systemic advocacy, further funding was allocated to the hospital redevelopment project, which enabled 32 hospital beds including six private rooms and two palliative care rooms to be built. The government also amended its Health Service Planning Policy to include consideration of local community needs in relation to palliative care and private rooms in the development of new services across the State.

Tips to help you get started

1. Understand your issue

What strategies have other people and groups used that worked well, and what has worked less well?

This involves doing research and gathering information about the issue. You can talk to other people, groups and organisations with similar issues to draw from their experiences. You can find out what has happened in the past and what may be planned for the future. Also find out from people what their needs are about the same issue.

2. Gather support

Who are your friends?

Find out whether other people or groups have similar issues and interests and whether they are willing to work with and/or support you. It is good to look for and create partnerships with other people, services or groups who have the same desire to achieve change. It is also useful to find out who has different views and why, as they may oppose your efforts and you will need to be prepared and be able to respond.

3. Develop a common goal

In addition to identifying people, groups and organisations with similar issues, it is essential to reach agreement on a common goal. While people may have issues in common, there may be differing opinions on what needs to be achieved. Unless all parties agree on a common goal there will be conflict around the steps to take and the people and organisations to be involved.

4. Put together a strategy

Once you have a common goal, you need an advocacy strategy or campaign to achieve it! The strategies will vary depending upon the issue. It is essential to plan the activities you will undertake and who will undertake them. You may need to agree on a leader/s to act as a spokesperson/s for the group. You also need to identify your key messages about your cause and what you want to achieve, and who you will approach about the issue.

Strategies may include meeting with or writing to decision-makers; holding community meetings/forums to gather public opinion and support; producing publications (including flyers, leaflets) to promote your issue; speaking or writing to your local Councillor or Member of Parliament; or using the media (radio, TV, newspapers) to raise awareness about the issue and goal.

If you do not have the time to form your own strategy or campaign to tackle the issue, supporting existing networks to champion the issue is another way to work towards the changes you seek. Networks are valuable in bringing people together who share common goals.

Reproduced with permission from Health Consumers Queensland, “Getting the Health Care you need: An advocacy toolkit for people using the healthcare system I Queensland”.

Next: Becoming a consumer representative

Systems Advocacy

Systems Advocacy